Mechanisms of Listening Effort in School Age Children who are Hard of Hearing

学龄听力障碍儿童的听力努力机制

• 批准号: 9502268
• 负责人: Elizabeth A. Walker
• 金额: $ 15.25万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9502268
• 关键词: Acoustics; Address; Adult; Affect; Age; Auditory; Child; Childhood; Clinical; Clinical Management; Cognition; Cognitive; Communication; Complex; Cueing for speech; Data; Development; Devices; Dimensions; Early Intervention; Environment; Evidence based intervention; Evidence based practice; Goals; Hearing; Hearing Aids; Income; Individual Differences; Knowledge; Learning; Linguistics; Literature; Measures; Mission; Noise; Patient Self-Report; Performance; Policies; Population Intervention; Process; Psyche structure; Public Health; Reaction Time; Reporting; Research; Research Proposals; Resources; Role; School-Age Population; Schools; Short-Term Memory; Signal Transduction; Speech; Testing; Theoretical model; United States National Institutes of Health; Variant; Vocabulary; Work; base; cognitive load; cognitive skill; early childhood; effective intervention; experience; hearing impairment; insight; multitask; programs; skills; social; sound; speech recognition; theories

1 ABSTRACT 2 Many children with mild to severe hearing loss are identified and receive early intervention at very young ages. 3 Even with this early intervention, however, children who are hard of hearing (CHH) experience challenges with 4 communication due to reduced access to the auditory signal. These challenges are further compounded in 5 school because CHH have increased difficulty perceiving speech in adverse acoustic conditions and most 6 listening conditions are characterized by poor acoustics. When listening in adverse conditions, CHH must exert 7 additional cognitive resources compared to children with normal hearing (CNH) in order to perceive an incoming 8 message. Consequently, they have fewer cognitive resources available to perform additional tasks and must 9 expend increased listening effort. Listening effort requires the coordination of low-level, bottom-up processes, 10 and higher-level, top-down processes. There is a lack of evidence regarding the interplay between auditory 11 access and higher-level cognitive skills in influencing individual differences in listening effort for CHH. This 12 knowledge gap hinders the understanding of the underlying mechanisms that drive listening effort in children 13 with hearing loss, which in turn, limits the ability to develop evidence-based interventions for this population. The 14 current proposal seeks to determine the factors that underlie increased listening effort in school-age CHH. This 15 proposal is based on a limited resources capacity theory, which posits that listeners require additional cognitive 16 resources to maintain optimal listening performance during adverse acoustic conditions, and this demand on 17 resources results in a decline in performance on secondary tasks. Specifically, the current proposal tests the 18 hypothesis that top-down processing, quantified by working memory and linguistic skills, is associated with 19 listening effort in school-age CHH, and this relationship is moderated by bottom-up processing, measured via 20 aided audibility. Two specific aims are proposed to test this hypothesis: Aim 1. To determine the effect of higher- 21 level cognitive-linguistic skills on listening effort in school-age children who are hard of hearing, and to evaluate 22 the extent to which auditory access influences the relationship between cognitive-linguistic skills and listening 23 effort. Aim 2. To identify the effects of hearing aid use and background noise on listening effort in children who 24 are hard of hearing. In Aim 1, working memory capacity, receptive vocabulary, and aided speech audibility will 25 be used to predict listening effort in varying levels of background noise. In Aim 2, listening effort for CHH will be 26 evaluated in aided and unaided conditions, in quiet and in background noise. In both aims, different dimensions 27 of listening effort will be captured, including reaction time, self-report measures, and speech recognition 28 performance. The data generated from this proposal will inform theoretical models regarding the integration of 29 low-level, acoustic-phonetic input and higher-level, cognitive-linguistic processes involved in listening, using a 30 mechanistic approach to examine listening effort. The proposed study will also provide empirical evidence for the 31 development of effective interventions for children with hearing loss, in both classroom and social settings.

1 摘要 2 许多患有轻度至重度听力损失的儿童在很小的时候就被发现并接受早期干预。 3 然而，即使进行了这种早期干预，听力困难儿童 (CHH) 仍会面临以下挑战： 4.由于听觉信号的获取减少而导致的沟通。这些挑战进一步加剧 5 所学校因为 CHH 在不利的声学条件下感知语音的难度增加，并且大多数学校 6 聆听条件的特点是声学效果较差。在不利条件下聆听时，CHH 必须发挥 与听力正常的儿童 (CNH) 相比，为了感知传入的声音，需要额外的 7 个认知资源 8 条消息。因此，他们可用于执行额外任务的认知资源较少，并且必须 9 加大倾听力度。倾听工作需要协调低级、自下而上的流程， 10 级及更高级别的自上而下流程。缺乏关于听觉之间相互作用的证据 11 影响 CHH 听力努力个体差异的访问和高级认知技能。这 12 知识差距阻碍了对推动儿童倾听努力的根本机制的理解 13 患有听力损失，这反过来又限制了为该人群制定循证干预措施的能力。这 14 目前的提案旨在确定导致学龄 CHH 加强听力努力的因素。这 15 提案基于有限资源能力理论，该理论假设听众需要额外的认知能力 16 种资源可在不利的声学条件下保持最佳的聆听性能，而这一需求 17 种资源会导致次要任务的性能下降。具体来说，当前的提案测试了 18 假设通过工作记忆和语言技能量化的自上而下的处理与 19 学龄 CHH 的听力努力，这种关系是通过自下而上的处理来调节的，通过测量 20 辅助听力。提出了两个具体目标来检验这一假设： 目标 1. 确定更高层次的效果 21 级认知语言技能对学龄听力困难儿童的听力努力进行评估 22 听觉访问对认知语言技能与听力之间关系的影响程度 23努力。目标 2. 确定助听器使用和背景噪音对以下儿童听力努力的影响 24 人有听力障碍。在目标 1 中，工作记忆能力、接受词汇量和辅助言语可听度将 25 可用于预测不同背景噪声水平下的听力效果。在目标 2 中，CHH 的倾听努力将是 26 人在有帮助和无帮助的条件下、安静和背景噪音下进行了评估。两个目标、不同维度 将捕获 27 项听力努力，包括反应时间、自我报告测量和语音识别 28 性能。该提案生成的数据将为有关整合的理论模型提供信息 29 个涉及听力的低级声学语音输入和高级认知语言过程，使用 30种检查听力努力的机械方法。拟议的研究还将为以下方面提供经验证据： 31 在课堂和社会环境中为听力损失儿童制定有效的干预措施。